How can my tooth hurt, but the dentist doesn’t find anything wrong?
Though the vast majority of toothaches are due to specific compromises in one or many teeth, the experience of tooth pain can be the result of referred pain. When referred pain is experienced, the site of the pain complaint is different than the origin of the pain. For this reason treating the site of the pain (in this case the teeth) will not produce relief. In my practice I commonly hear toothache complaints that are not associated with the teeth but are rather due to tight and irritable muscles, migraine mechanisms or nerves that are firing excessively. This knowledge allows me to make the correct diagnosis first and then treat the cause, instead of the location of the pain symptom. 

I was told that I have a TMJ problem and that I need my bite corrected to get better. Is that my only option?
In the majority of cases that I see bite correction is not the primary treatment selected and often times I get patients feeling better without touching their teeth at all. Since the way the teeth come together (called occlusion) is most often not the cause of TMJ problems, using other treatments such as exercises, oral appliances, medication, physiotherapy and education is all that is necessary to getting your problem under control.

Why do I clench and grind my teeth at night?
The medical community does not fully understand why people grind and clench their teeth at night, but it appears that anything that arouses the brain while you sleep could trigger these activities. A crying baby, a painful back, a chronic asthmatic condition or poor sleep conditions for instance can be a source of arousal. Though stress can be a source of arousal it is not the only problem that must be considered. In my practice, I will help you find the source of those arousals and put together a plan of action that helps you feel better in the morning.

My jaw really aches, but chewing can make it feel better. How can that be?
It is not uncommon for the jaw muscles to become tight and painful as a result of problems in the neck and shoulder region. Because of an intimate relationship between the nerves that serve the jaw and those that serve the upper neck, a problem in the neck can often tighten the jaw muscles leading to soreness and pain. As a result, chewing which can bring fresh blood and oxygen to the tight jaw muscles makes the pain and tension ease. Long-term treatment must therefore focus on the neck region. I have found that a combination of exercises, muscle injections, and physical therapy go a long way in getting these problems under control.

My jaw doesn’t hurt, but can anything be done with the clicking and morning locking I experience?
Jaw clicking and locking symptoms result from loose ligaments, friction, dryness, bone irregularity, muscle incoordination and slipping cartilage in the Temporomandibular Joints. The use of specific types of oral appliances can be extremely effective in preventing jaw locking and diminishing joint sounds and I can determine which appliance is best for your problem. In addition I can prescribe certain medications for a short period of time that can help you sleep more restfully and experience less jaw symptoms in the morning.

I was diagnosed with a TMJ problem and told that I would have to live with it for the rest of my life. Is that true?
Like most other orthopedic problems, the vast majority of jaw related problems can be solved or managed to the point where symptoms are no longer of concern. The key is proper diagnosis and once established education, exercises, short-term medications, physiotherapy and oral appliances is all that is required for excellent results to be achieved. These are not lifetime problems for the majority of my patients.

If I snore, does that mean I have Sleep Apnea?
The answer to this question is no. Snoring can occur without the presence of a sleep apnea condition. Since snoring occurs due to turbulence in the airway, full evaluation is recommended as a less significant problem called upper airway resistance syndrome may be present which can lead to cardiovascular stress that is often associated with heart attacks or strokes. Whether your snoring is just a social problem or a source of stress to your heart, my practice will guide you towards making the best decisions for your problem. I can fit you for an oral appliance or put you in the hands of an ear nose and throat doctor that can determine if your nose is part of the snoring problem.

I am currently 45 years old and have to use a mask over my face (CPAP) when I sleep to help my apnea. Can I use an oral appliance on some nights during the week to break up the monotony and also make traveling easier?
Though CPAP therapy is the gold standard of care for obstructive sleep apnea, oral appliances have proved to be very effective as well. In fact oral appliances cannot only improve breathing efficiency, but they have been shown to reverse the blood vessel damage that occurred when an apnea condition was untreated. The interchange of CPAP and oral appliance therapy in my mind is considered the perfect marriage between two treatments that influence the airway in different but effective ways.

I have been to my family doctor, a sinus specialist and a neurologist but nobody knows why I have a facial headache and ear pain. Is the pain in my head?
I know it is frustrating that despite multiple medical evaluations your pain has not been diagnosed. This however does not mean that your pain is not real. If your situation is similar to the vast majority of patients that I see, it is likely that your pain is of muscle origin and I can help. Evaluation in the office will likely get you started on the right path.

My 10-year-old daughter snores terribly and grinds her teeth to the point that they hurt in the morning. Is there anything that can be done to help her?
Though 10 years old seems young for these problems, they are not uncommon. In fact the factors that are causing her snoring may well be related to her tooth grinding as well. In my office I can evaluate her situation and determine whether she has an airway problem. Once this is determined proper treatment can be planned.

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